Provider Demographics
NPI:1831926427
Name:CUTILLO, GAIL ANN
Entity type:Individual
Prefix:
First Name:GAIL
Middle Name:ANN
Last Name:CUTILLO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:64 MAIN ST FL 2
Mailing Address - Street 2:
Mailing Address - City:KEENE
Mailing Address - State:NH
Mailing Address - Zip Code:03431-3701
Mailing Address - Country:US
Mailing Address - Phone:603-283-1574
Mailing Address - Fax:
Practice Address - Street 1:40 AVON ST
Practice Address - Street 2:
Practice Address - City:KEENE
Practice Address - State:NH
Practice Address - Zip Code:03431-3516
Practice Address - Country:US
Practice Address - Phone:603-357-4400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-17
Last Update Date:2024-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH019892-22164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse